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Savings Plus OA Managed Choice® POS Network Overview
Savings Plus OA Managed Choice® POS network overview The Savings Plus service area consists of all of Los Angeles, Orange, San Diego and Ventura counties and portions of Riverside and San Bernardino counties (excluding ZIP codes that begin with 922 and 923). All nonemergency services performed outside of the California Savings Plus OA Managed Choice POS network of doctors and hospitals will be paid at the out-of-network benefits level. Information updated June 2020 and is subject to change without notice. For a list of doctors and hospitals that participate in the Savings Plus OA Managed Choice POS network, log in to your member website on Aetna.com and use our provider search. Adventist Health Glendale Good Samaritan Hospital (Los Angeles) Adventist Health Simi Valley Healthbridge Children’s Hospital Adventist Health White Memorial Hemet Global Medical Center AHMC Anaheim Regional Medical Center Henry Mayo Newhall Memorial Hospital Alhambra Hospital Medical Center Hoag Hospital Irvine Alvarado Hospital Medical Center Hoag Memorial Hospital Presbyterian Anaheim Global Medical Center Hoag Orthopedic Institute Antelope Valley Hospital Hollywood Presbyterian Medical Center Beverly Hospital Huntington Beach Hospital Centinela Hospital Medical Center Huntington Memorial Hospital Chapman Global Medical Center Keck Hospital of USC CHOC Children’s at Mission Hospital La Palma Intercommunity Hospital Children’s Hospital Los Angeles Laguna Beach Campus of Mission Hospital CHOC Children’s Lakewood Regional Medical Center Chino Valley Medical Center -
Californiachoice® Small Group Advantage PPO Three-Tier Hospital Network
CaliforniaChoice® Small Group Advantage PPO three-tier hospital network With the CaliforniaChoice Advantage PPO plans, you have a choice of tiers (or levels) of hospitals to visit. Tier one hospitals offer the greatest savings to you. Tier two hospitals have the second best level of savings. Tier three hospitals — or out-of-network hospitals — offer the least out-of-pocket savings, but you’ll still be covered. Keep in mind that the tier levels aren’t based on the quality of care given at each hospital. They’re based on which hospitals have shown they’re better able to give quality care that’s also cost effective. Our three-tier levels* are: }}Tier 1 — PPO network hospitals with lower-negotiated hospital reimbursement rates. }}Tier 2 — the remaining PPO network hospitals. }}Tier 3 — non-network hospitals. * The tier levels are not based on the quality of care given at each hospital. Instead, each level stands for the hospitals that show 19685CABENABC 08/15 the best use of health care dollars. CaliforniaChoice® Small Group Advantage PPO three-tier hospital network Here is a list of the Tier-1 and Tier-2 hospitals included in the network. Any hospital not listed is considered out of network. Hospital County Tier St Rose Hospital Alameda 1 Alameda Hospital Alameda 1 Children’s Hospital Oakland Alameda 2 Valleycare Medical Center Alameda 2 Washington Hospital Alameda 2 Sutter Amador Health Center Pioneer 1 Sutter Amador Health Center Plymouth 1 Sutter Amador Hospital Amador 1 Oroville Hospital & Medical Center Butte 1 Feather River Hospital -
Emergency Behavioral Health Services
ALERT #24 ___________________ October 5, 2007 EMERGENCY BEHAVIORAL HEALTH SERVICES POLICIES AND PROCEDURES FOR EMERGENCY SERVICES PROGRAMS AND HOSPITAL EMERGENCY DEPARTMENTS FOR MBHP MEMBERS AND UNINSURED CONSUMERS The following information should be communicated immediately to other appropriate staff in your organization. The Massachusetts Behavioral Health Partnership (MBHP) is the company that manages behavioral health (mental health and substance abuse) services for MassHealth’s Primary Care Clinician (PCC) Plan Members*. Additionally, MBHP is contracted with the Department of Mental Health to manage most of the Emergency Services Programs (ESPs) across the Commonwealth. In that role, MBHP is issuing this Alert to hospital Emergency Departments (EDs), MBHP network providers, and other interested stakeholders in order to provide clarification and guidance relative to the management of behavioral health emergencies in the ED setting. More specifically, this Alert delineates the roles and responsibilities of the Emergency Services Programs (ESPs) and describes an individual’s progression through this system, with a goal of expediting his or her movement through the hospital ED and into acute behavioral health services, as medically necessary. ESPs function as a “safety net” for all citizens of the Commonwealth regardless of age, payer, or ability to pay. It is important to note that the policies and procedures in this Alert applies to those populations for whom the ESPs are contracted with MBHP to serve, which includes MBHP members, MassHealth (non-MCO enrolled) Members, uninsured consumers, and DMH consumers. However, it is also important to note that MassHealth also requires the four Managed Care Organizations (MCOs) contracted with MassHealth to utilize the ESP system for emergency behavioral health services for MassHealth MCO enrolled Members. -
Access+ HMO 2021Network
Access+ HMO 2021Network Our Access+ HMO plan provides both comprehensive coverage and access to a high-quality network of more than 10,000 primary care physicians (PCPs), 270 hospitals, and 34,000 specialists. You have zero or low copayments for most covered services, plus no deductible for hospitalization or preventive care and virtually no claims forms. Participating Physician Groups Hospitals Butte County Butte County BSC Admin Enloe Medical Center Cohasset Glenn County BSC Admin Enloe Medical Center Esplanade Enloe Rehabilitation Center Orchard Hospital Oroville Hospital Colusa County Butte County BSC Admin Colusa Medical Center El Dorado County Hill Physicians Sacramento CalPERS Mercy General Hospital Mercy Medical Group CalPERS Methodist Hospital of Sacramento Mercy Hospital of Folsom Mercy San Juan Medical Center Fresno County Central Valley Medical Medical Providers Inc. Adventist Medical Center Reedley Sante Community Physicians Inc. Sante Health Systems Clovis Community Hospital Fresno Community Hospital Fresno Heart and Surgical Hospital A Community RMCC Fresno Surgical Hospital San Joaquin Valley Rehabilitation Hospital Selma Community Hospital St. Agnes Medical Center Glenn County Butte County BSC Admin Glenn Medical Center Glenn County BSC Admin Humboldt County Humboldt Del Norte IPA Mad River Community Hospital Redwood Memorial Hospital St. Joseph Hospital - Eureka Imperial County Imperial County Physicians Medical Group El Centro Regional Medical Center Pioneers Memorial Hospital Kern County Bakersfield Family Medical -
Community Choice Acute Care Hospital Listing Effective July 1, 2017 When You Use a Community Choice Hospital, You Pay a $275 Inpatient Copay Per Calendar Quarter
UNICARE STATE INDEMNITY PLAN Community Choice Acute Care Hospital Listing Effective July 1, 2017 When you use a Community Choice hospital, you pay a $275 inpatient copay per calendar quarter. Community Choice members can also use additional hospitals for the same $275 copay for certain complex procedures and neonatal ICUs. To look for hospitals, go to unicarestateplan.com and, under the Quick Links tab on the Members page, select Look for health care providers. When you use non-Community Choice hospitals, your out-of-pocket costs are higher. Addison Gilbert Hospital Lawrence Memorial Hospital Anna Jaques Hospital Leominster Hospital (UMass Memorial) Athol Memorial Hospital Leonard Morse Hospital Baystate Franklin Medical Center Lowell General Hospital Baystate Medical Center Mary Lane Hospital (Baystate) Berkshire Medical Center Massachusetts Eye and Ear Beth Israel Deaconess Medical Center – Boston Melrose-Wakefield Hospital Beverly Hospital Mercy Medical Center Brockton Hospital Merrimack Valley Hospital Burbank Hospital (UMass Memorial) Milford Regional Medical Center Cambridge Hospital Milton Hospital (Beth Israel Deaconess) Cape Cod Hospital Morton Hospital Carney Hospital Mount Auburn Hospital Charlton Memorial Hospital Nashoba Valley Medical Center Children’s Hospital Boston Needham Hospital (Beth Israel Deaconess) Cooley Dickinson Hospital New England Baptist Hospital *Dana-Farber Cancer Institute (Boston location only) Noble Hospital (Baystate) Emerson Hospital Norwood Hospital Everett Hospital (formerly Whidden Hospital) Plymouth -
California Statewide Trauma System Triage and Transfer Resource Guide 2019
California Statewide Trauma System Triage and Transfer Resource Guide 2019 Emergency Medical Services Authority State Trauma Advisory Committee Howard Backer, MD, MPH, FACEP Director EMS Authority Daniel R. Smiley Chief Deputy Director EMS Authority Thomas McGinnis Chief, EMS Systems Division EMS Authority Elizabeth Winward State Trauma Systems Coordinator EMS Authority x For an electronic copy of this publication, please visit California Emergency Medical Services Authority’s website (http://www.emsa.ca.gov/XXXXX ii January 2019 CONTENTS INTRODUCTION 1 CALIFORNIA STATUTORY/REGULATORY AUTHORITY 2 Article 1. Local EMS Agency 2 Article 3. Transfer Agreements 2 Code of Regulations, Title 22, Division 9, Chapter 7 2 BACKGROUND 3 RE-TRIAGE AGREEMENTS, GUIDELINES, AND POLICIES 4 PERFORMANCE IMPROVEMENT 5 EDUCATION 6 REFERENCES 7 APPENDICES INTRODUCTION 8 Appendix 1: Hospital Council of Northern & Central California Patient 9 Transfer Agreement Appendix 2: Central California Regional Trauma System 18 Suggested Criteria for Consideration of Transfer to a Trauma Center Appendix 3: Riverside County EMS Agency Continuation of Trauma Care 20 Appendix 4: City and County of San Francisco Trauma Re-Triage 23 Appendix 5: Contra Costa EMS 24 iii CONTENTS Appendix 6: Inland Counties EMS Agency Continuation of Care 27 Appendix 7: Los Angeles County EMS Agency Trauma Triage 32 Appendix 8: North Regional Trauma Coordinating Committee 33 Guidelines for Transfer to a Trauma Center Appendix 9: Routine Follow-up Communication Form 37 iv INTRODUCTION This resource is designed to assist the local EMS agencies (LEMSA) in the development of transfer and triage policies, guidelines and processes throughout California.1 In particular, this resource focuses on the concept of emergency transfer of critical trauma patients also commonly called re-triage. -
Los Angeles County: 2015 Data
Using Data to Drive Change: California Continues to Increase In-hospital Exclusive Breastfeeding Rates A Policy Update on California Breastfeeding and Hospital Performance Produced by California WIC Association and the UC Davis Human Lactation Center Los Angeles County: 2015 Data Exclusive breastfeedng protects California’s success is driven by mothers' and babies' health evidence Breast milk provides all the nutrients infants need For more than 15 years, decision-makers and as well as specific factors needed to build a strong advocates in California have used hospital-level immune system.1 surveillance data to coordinate and monitor efforts to improve the quality of perinatal care. In-hospital support is crucial to breastfeeding mothers’ success.2-4 The greatest health benefits are Data show that mothers who experience more seen when exclusive breastfeeding continues for 6 supportive practices (such as early breastfeeding months. It is estimated that $3.0 billion in medical initiation and limited supplementation) are more costs would be saved if all U.S. infants were fed likely to breastfeed exclusively in the hospital and according to the current guidelines.5 beyond.6 Hospitals that have instituted Baby-Friendly policies California has the most Baby-Friendly Hospitals have high rates of breastfeeding, no matter where they in the nation and legislation requiring that all are located or what populations they serve.4,6 As more maternity hospitals adopt these or similar policies California hospitals have adopted these evidence- by -
Medi-Cal Managed Health Care Options in San Diego County
Medi-Cal Managed Health Care Your Medi-Cal Managed Care Health Plan Choices Options in San Diego County This material is being provided to help you better understand your choices. It is not an endorsement of any specific Medi-Cal Health Plan. Standard Medi-Cal Covered Services Welcome to Medi-Cal Managed Care Benefits Alvarado Hospital & Medical Center Scripps Mercy Hospital Chula Your Medi-Cal benefits can now be provided by a Medi-Cal Managed Care Health Plan. A Palomar Medical Center Vista Managed Care Health Plan gives you access to a network of doctors, clinics, specialists, Plan Network Paradise Valley Hospital Sharp Chula Vista Medical Center pharmacies and hospitals. Hospitals* Pomerado Hospital Sharp Coronado Hospital How Does Managed Care Work? Rady Children’s Hospital San Diego Sharp Grossmont Hospital Each Medi-Cal Managed Care Health Plan has a list of primary care providers you can choose *Call your Scripps Green Hospital Sharp Mary Birch Hospital for from. If you have a doctor now, you will need to find out if that doctor belongs to a Medi-Cal provider about Scripps Memorial Hospital Women & Newborns Managed Care Health Plan. Your primary care provider will be responsible for managing your using other Encinitas Sharp Memorial Hospital overall health care and referring you to other doctors if needed. locations in an Scripps Memorial Hospital La Jolla Sharp Mesa Vista Hospital Who Can Join a Medi-Cal Managed Care Health Plan? emergency. Scripps Mercy Hospital San Diego Tri-City Medical Center Anyone who is on Medi-Cal, lives in San Diego County, and has a qualifying aid code may UCSD Medical Center – Hillcrest choose a Medi-Cal Managed Care Health Plan. -
Hospital Organ Donation Campaign Recognition for Outreach
Hospital Organ Donation Campaign Recognition for Outreach The hospitals listed below reached gold, silver, and bronze recognition levels for their organ, eye, and tissue donation and registration efforts between August 1, 2014, and April 30, 2015. The hospitals worked closely with their organ procurement organizations and Donate Life America affiliates to educate and register new donors. In many states, the participation of state hospital associations was pivotal to the hospitals’ efforts. DLA and hospital association participation is indicated in the title line for each state. OPO participation is listed in the OPO recogni- tion list at the end of the document. SEARCH BY STATE: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z OPO RECOGNITION ALABAMA • Donate Life Alabama 1 0 0 East Alabama Medical Center Y ARIZONA • Donate Life Arizona 3 11 28 • Arizona Hospital and Healthcare Association Abrazo Arizona Heart Hospital Y Abrazo Central Campus Y Abrazo Scottsdale Campus Y Abrazo West Campus Y American Liver Foundation Y Banner Boswell Medical Center Y Banner Casa Grande Regional Medical Center Y Banner Del E. Webb Medical Center Y Banner Desert Medical Center and Cardon Children’s Medical Center Y Banner Estrella Medical Center Y Banner Gateway Medical Center and Banner MD Anderson Cancer Center Y Banner Goldfield Medical Center Y Banner Ironwood Medical Center Y Banner Thunderbird Medical Center Y Banner University Medical Center—Tucson and South Campus* Y Barnet Dulaney Perkins Eye Center Y Carondelet St. Mary’s Hospital Y Chandler Regional Medical Center Y Cobre Valley Regional Medical Center Y Flagstaff Medical Center Y * denotes transplant centers 1 HonorHealth Deer Valley Medical Center Y HonorHealth John C. -
Appendix S3 C Diff Rates
Clostridium Difficile Infection (CDI) Standardized Infection Ratios (SIRs) in California General Acute Care Hospitals California Department of Public Health 2016 Data Lower is better, goal is 1.0 or less Infections Infections Patient SIR CI 95 Lower SIR CI 95 Upper Year CDPH Facility ID Facility Name County SIR Score Comparison SIR in 2015 Reported Predicted Days Limit Limit 2016 930000060 Glendora Community Hospital Los Angeles 8 2.81 5849 2.85 1.32 5.41 Worse 0.95 2016 60000007 Children's Hospital of Orange County Orange 58 21.96 47689 2.64 2.02 3.39 Worse 1.5 2016 930000035 Silver Lake Medical Center Los Angeles 20 7.74 16124 2.58 1.62 3.92 Worse 1.5 2016 250000344 Southwest Healthcare System, Wildomar Riverside 47 18.35 33228 2.56 1.9 3.38 Worse 2.3 2016 110000056 Sonoma Valley Hospital Sonoma 7 2.85 4759 2.45 1.07 4.85 Worse 1.79 2016 250000507 Southwest Healthcare System, Murrieta Riverside 27 11.26 24726 2.4 1.61 3.44 Worse 1.51 2016 930000082 Community Hospital Long Beach Los Angeles 20 8.96 15786 2.23 1.4 3.39 Worse 1.25 2016 930000108 Monterey Park Hospital Los Angeles 13 5.89 20399 2.21 1.23 3.68 Worse 2.29 2016 250000101 San Gorgonio Memorial Hospital Riverside 34 15.52 12601 2.19 1.54 3.03 Worse 1.63 2016 930000105 Olympia Medical Center Los Angeles 59 27.59 27338 2.14 1.64 2.74 Worse 1.89 2016 40001397 Fresno Heart and Surgical Hospital Fresno 13 6.44 11680 2.02 1.12 3.37 Worse 2.11 2016 30000123 Memorial Medical Center Stanislaus 85 43.6 77513 1.95 1.57 2.4 Worse 2.01 2016 60000015 Huntington Beach Hospital Orange 13 6.88 -
Sharp Value Provider Network Overview
Sharp Value Provider Network Overview Physicians • Hospitals • Urgent Care Centers • Pharmacies • Other Facilities Effective January 1, 2018 Sharp Value Provider Network Medical Groups At Sharp Health Plan, we understand the importance of selecting a network that fits your lifestyle and budget. As a member, you’ll join a family of award-winning medical groups, physicians and hospitals dedicated to meeting your health care needs. The Sharp Value Provider Network offers access to a core group of physicians and hospitals to provide you with greater value. With Sharp Value, you’ll have access to more than 1,900 physicians, including Primary Care Physicians and specialists. Sharp Rees-Stealy (SRS) This medical group offers a network of more than 470 physicians, including Primary Care Physicians and specialists. Admitting hospitals include Sharp HealthCare facilities and Rady Children’s Hospital. SRS physicians are located throughout San Diego County, including: • Carmel Valley • Frost Street • Mt. Helix • San Carlos • Chula Vista • Genesee • Murphy Canyon • San Diego • Del Mar • La Mesa • Otay Ranch • Scripps Ranch • Downtown San Diego • La Mesa West • Point Loma • Sorrento Mesa • El Cajon • Mira Mesa • Rancho Bernardo Sharp Community Medical Group (SCMG) This medical group offers a network of more than1,090 physicians, including Primary Care Physicians and specialists. Admitting hospitals include Sharp HealthCare facilities, Rady Children’s Hospital and Palomar Health facilities.1 SCMG, SCMG Inland North, SCMG Graybill and SCMG Arch Health -
Wayfair Preferred (Narrow) Network Plan Hospitals
Wayfair Preferred (Narrow) Network Hospitals Hospital Name City State Addison Gilbert Hospital Gloucester MA Anna Jaques Hospital Newburyport MA BayRidge Hospital (acute psychiatric hospital) Lynn MA Beth Israel Deaconess Medical Center—Boston Boston MA Beth Israel Deaconess Hospital—Milton Milton MA Beth Israel Deaconess Hospital—Needham Campus Needham MA Beth Israel Deaconess Hospital—Plymouth Plymouth MA Beverly Hospital Beverly MA Boston Children’s Hospital Boston MA Boston Medical Center Boston MA Brigham and Women’s/Mass General Health Care Center at Patriot Place Foxborough MA Cambridge Health Alliance—Cambridge Campus Cambridge MA Cambridge Health Alliance—Somerville Campus Somerville MA Cambridge Health Alliance—Whidden Campus Everett MA Carney Hospital Dorchester MA Clinton Hospital Clinton MA Cooley Dickinson Hospital Northampton MA Emerson Hospital Concord MA Faulkner Hospital Jamaica Plain MA Good Samaritan Medical Center Brockton MA HealthAlliance Hospitals—Burbank Campus Fitchburg MA HealthAlliance Hospitals—Leominster Campus Leominster MA Heywood Hospital Gardner MA Holyoke Medical Center Holyoke MA Lahey Hospital and Medical Center Burlington MA Hospital Name City State Lahey Medical Center Peabody MA Lawrence General Hospital Lawrence MA Lawrence Memorial Hospital Medford MA Lowell General Hospital (includes the campus Lowell MA formerly known as Saints Medical Center) Massachusetts Eye and Ear®´ Infirmary Boston MA Mass General/North Shore Center for Outpatient Care Danvers MA Melrose-Wakefield Hospital Melrose MA Mercy